V1881: ROBOTIC PARTIAL CYSTECTOMY FOR URACHAL TUMOR
VideoIntroduction and Objectives
Herein we describe our technique of robotic partial cystectomy for urachal tumor and tips and trics to achieve safe surgical margins.
We report the case of a 68 years old woman who had an incidental bladder mass discovered on Ultrasound for ovarian cysts. Patient denied any urinary symptoms, urinary infection or hematuria. Preoperative abdominal/pelvic CT imaging revealed 5cm anterior and superior bladder wall mass within a urachal remnant. On cystoscopy, a solid anterior bladder wall lesion was seen at the dome with surrounding inflammatory reaction. Initial needle biopsy showed a non specific inflammatory bladder tumor. _x000D_ A step by step technique is described: 1) Bladder mobilization and urachus dissection, 2) Identification of tumor by transillumination with flexible cystoscopy, 3) Enbloc Partial cystectomy, urachal and umbilical resection, 4) Cystorrhaphy.
Operative time was 180 minutes. Estimated blood loss was 100 cc and the length of hospital stay was 2 days. Final pathology reported a benign inflammatory tumor of bladder and urachus. Surgical margins were negative. No lymph node involvement was noted. Bladder catheter was removed at post-operative day 7 after a cystogram showing no leak. No intraoperative or postoperative complications were reported.
Robotic surgery represents a minimally invasive treatment option for resection of urachal tumor. Transillumination using a flexible cystoscope, facilitate marking of tumor margins.